| NPI | 1275935462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501015121) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2018-10-02 |